crossing96/oncoscreening huggingface dataset:
Effectiveness of Video-Based Instructions on Urostomy Self-Care in Patients Undergoing Radical Cystectomy with Ileal Conduit Urinary Diversion.	OBJECTIVE: To evaluate the effectiveness of video-assisted stoma-care teaching in improving patients' confidence and skills in stoma management. STUDY DESIGN: Quasi-experimental study. Place and Duration of the Study: Section of Urology, Department of Surgery, The Aga Khan University Hospital, Karachi, Pakistan, from December 2023 to May 2024. METHODOLOGY: Nineteen patients underwent radical cystectomy with ileal conduit, of whom 15 met the eligibility criteria. On the third postoperative day, patients received verbal stoma-care instructions, followed by video-assisted teaching at their first clinic visit. A self-efficacy questionnaire was administered pre- and post-intervention. The Wilcoxon signed-rank test compared the scores, with p <0.05 deemed statistically significant. RESULTS: The median self-efficacy score improved significantly from 24/65 before the video intervention to 61/65 afterwards (p <0.05). Improvements were observed across stoma-care, application, and confidence domains. Pre-intervention, only one patient demonstrated high confidence, whereas post-intervention, all patients achieved high self-efficacy. CONCLUSION: Video-assisted stoma-care teaching significantly improved patients' confidence and skills in managing their stoma after radical cystectomy. This method provides a valuable, repeatable tool to enhance patient outcomes and quality of life. KEY WORDS: Radical cystectomy, Urinary diversion, Ileal conduit, Stoma management, Video-assisted teaching, Self-efficacy, Confidence, Patient confidence, Learning tool, Quality of life.	bladder
Comparison of spinal versus general anaesthesia in high-risk non-muscle invasive bladder cancer: study protocol for a randomised controlled trial.	INTRODUCTION: The impact of anaesthesia modality on oncological outcomes in patients with high-risk non-muscle invasive bladder cancer (NMIBC) remains uncertain. Emerging evidence suggests that anaesthetic agents and techniques may influence tumour biology and recurrence through immunomodulatory and neuroendocrine pathways. However, prospective randomised trials comparing spinal and general anaesthesia in this population are lacking. METHODS AND ANALYSIS: This single-centre, prospective, parallel-arm randomised controlled trial will enrol 370 patients with clinically suspected high-risk NMIBC undergoing transurethral resection of bladder tumour. Participants will be randomised 1:1 to receive either spinal or general anaesthesia. The primary endpoint is time to recurrence over a 104-week follow-up period. Secondary endpoints include time to progression, Bacillus Calmette-Guérin (BCG) unresponsiveness and a composite oncological event. Additional secondary outcomes include postoperative opioid consumption (morphine equivalents), obturator jerk occurrence, acute urinary retention and tolerance to immediate intravesical chemotherapy. Safety outcomes will include treatment-emergent adverse events, Clavien-Dindo graded surgical complications, haemorrhagic events and anaesthesia-related risks. Exploratory endpoints involve perioperative biomarker analyses. Data will be analysed on an intention-to-treat basis. ETHICS AND DISSEMINATION: Recruitment has not yet started. It is expected to begin in December 2025 and to be completed by June 2029. The planned follow-up period for each participant is 104 weeks. This manuscript is based on protocol V.1.0, dated March 2025. Results will be disseminated through peer-reviewed journals and conference presentations TRIAL REGISTRATION NUMBER: NCT06982690.	bladder
Preliminary Functional Outcome Following Robotic Intracorporeal Orthotopic Ileal Neobladder with Integrated Pelvic Fascial Structure-Sparing in Males with Bladder Cancer.	PURPOSE: To describe our integrated pelvic fascial structure-sparing (IPFSS) technique for robotic-assisted radical cystectomy (RARC) with intracorporeal orthotopic neobladder (ONB) reconstruction and to evaluate its impact on urinary continence and sexual function in male patients. METHODS: This retrospective observational study was conducted at a single high-volume center. Male bladder cancer patients who underwent IPFSS RARC with ONB were included. Demographic, clinical, and pathological data were collected. Functional outcomes were evaluated and compared with a cohort of patients who underwent conventional non-nerve-sparing RARC. RESULTS: Thirty-six patients were included in the IPFSS group and 42 in the conventional group. RARC with intracorporeal urinary diversion was successfully completed in all patients without open conversion. The mean total operative time was 387.9 minutes in the IPFSS group and 392.0 minutes in the conventional group (p = 0.465). At 3 months post-surgery, 30 patients (83%) in the IPFSS group achieved daytime continence (0-1 pads), compared to 14 patients (33%) in the conventional group. By 6 months, daytime continence increased to 35 patients (97%) in the IPFSS group, while 28 patients (67%) in the conventional group achieved similar results. At 6 months, 30 patients (83%) in the IPFSS group reported full potency with or without phosphodiesterase type 5 (PDE5) inhibitors, compared to only 3 patients (7%) in the conventional group. CONCLUSION: We present a feasible surgical technique for RARC that involves holistic preservation of the pelvic fascial architecture. This approach is associated with a rapid recovery of daytime continence and sexual function in male patients.	bladder
The current role of photodynamic diagnosis (PDD) in the management of non-muscle invasive bladder cancer: the Italian Society of Urology (SIU) Position Paper.	Photodynamic diagnosis (PDD) significantly enhances the detection of bladder cancer (BCa) and is able to reduce the risk of disease recurrence, although it may not affect disease progression and mortality rates. Despite its advantages, widespread adoption of PDD is limited by cost considerations and the absence of unified guidelines on its application, highlighting the need for continued evaluation of its cost-effectiveness across different healthcare settings. To date, no specific recommendations for PDD in non-muscle invasive bladder cancer (NMIBC) management have been provided by the Italian Society of Urology (Società Italiana di Urologia, SIU). Therefore, the aim of this paper is to report on the position of SIU on the role of PDD in NMIBC. According to available evidence and international guidelines (i.e., European Association of Urology, American Association of Urology, National Comprehensive Cancer Network and other national guidelines) on BCa, a Panel of twelve Italian urologists with long and renowned experience in treating BCa defined current indications for PDD in the management of NMIBC. The final document was ultimately reviewed and approved by the expert Panel prior to publication. The consensus highlighted the role of PDD during the initial transurethral resection of the bladder (TURB) to detect carcinoma in situ (CIS) and small papillary lesions that might otherwise be missed, leading to disease persistence. Additionally, in clinical scenarios such as positive urine cytology with negative cystoscopy, PDD-guided biopsies can significantly increase the detection of CIS. For cases involving larger or multifocal tumors, or atypical macroscopic features during cystoscopy, PDD is valuable for identifying subtle high-grade disease elements, thereby facilitating more precise risk stratification and targeted treatment planning. In the setting of re-TURB, aiming to detect the presence and extent of concomitant CIS and to gain all possible additional information, PDD may be used in all procedures if not already performed during initial resection. Finally, PDD may be used for disease recurrence in patients with a history of HG NMIBC and to evaluate the response of CIS to Bacillus Calmette-Guérin (BCG). This position paper of the SIU highlights the current recommendation for the use of PDD in the management of NMIBC, from initial TURB, to re-TURB and follow-up.	bladder
Copper single-atom-based flexible aptamer biochip for simultaneous monitoring of bladder cancer-related bacteria.	R apid and accurate detection of pathogenic bacteria is crucial for disease diagnosis in clinical practice. The infection of Escherichia coli (E. coli) and Staphylococcus aureus (S. aureus) is closely related to the development and complications of patients with bladder cancer. In this study, an aptamer biochip for E. coli and S. aureus simultaneous detection was developed based on copper single atom material (Cu-SAC) and gold nanoparticles (AuNPs) via high-resolution electrohydrodynamic (EHD) printing technology. The main strategy was based on the specific recognition of aptamer and the signal amplification of AuNPs/Cu-SAC. Following aptamer immobilization, the electrochemical signal gradually decreased. Using this proposed electrochemical aptamer biochip, E. coli and S. aureus can be quantified at a linearity range of 10-1.0 × 10(8) CFU mL(-1). The limit of detection (LOD) was as low as 3 CFU mL⁻(1). The outstanding signal amplification performance is due to the combination of Cu-SAC and AuNPs, which efficiently supply electrons to Fe(3)⁺, thereby facilitating the Fe(3+)/Fe(2+) cycle. Furthermore, employing this portable biochip enables simultaneous measurements of E. coli and S. aureus concentrations in urine and milk samples with acceptable recoveries. This portable biochip holds significant potential for pathogenic bacteria detection  in field-based applications. Moreover, it is expected to provide a powerful auxiliary means for the monitoring  of bladder cancer patients.	bladder
Excavatolide E triggers oxidative stress-associated apoptosis and DNA damage to inhibit bladder cancer cell proliferation.	BACKGROUND: Excavatolide E (EXCE), a biocompound extracted from the gorgonian octocoral Briareum excavatum, has received limited attention for its anticancer properties, especially in the context of bladder cancer. METHODS: Cell viability, flow cytometry, and Western blotting were performed to assess the antiproliferative effects and mechanisms against bladder cancer cells. RESULTS: In the present study, the impacts and mechanisms of EXCE's antiproliferative effects on bladder cancer cells were assessed, along with its impacts on normal cells. EXCE selectively inhibited proliferation of bladder cancer cells, as compared to normal cells, i.e., selectivity index > 2, and induced greater oxidative stress in bladder cancer cells than normal cells, regarding the induction of cellular and mitochondrial ROS, as well as the depletion of mitochondrial membrane potential. Moreover, EXCE triggered higher levels of apoptosis, both extrinsic and intrinsic caspase activation, and DNA damage in bladder cancer cells than in normal cell; these EXCE-triggered antiproliferative mechanisms were alleviated by N-acetylcysteine (NAC), a ROS inhibitor. CONCLUSION: Therefore, EXCE's antiproliferative activity offers a promising therapeutic approach for targeting bladder cancer cells by modulating oxidative stress, while preserving the safety of normal cells.	bladder
Photodynamic therapy with zinc phthalocyanine enhances cisplatin sensitivity of human muscle-invasive bladder cancer cells by downregulation of PI3K/AKT/mTOR signaling pathway.	Cisplatin (CIS) is mainly used as a chemotherapeutic drug for bladder cancer (BLC). However, the total response of CIS-based chemotherapy in BLC remains unsatisfactory owing to the complex genomic differences, pathological subtypes, and drug resistance. In BLC cells, activation of the PI3K/AKT/mTOR signaling pathway escalates cell proliferation, invasion, and migration. Furthermore, due to the increase in BLC cell viability resulting from PI3K/AKT/mTOR upregulation, BLC cells may acquire resistance to anti-cancer treatments such as CIS-based chemotherapy. Also, the BLC response to CIS may be enhanced when combined with other therapeutic approaches. One such approach is photodynamic therapy (PDT), where a photosensitizer (PS) generates reactive oxygen species (ROS) after illumination of target cells. In this study, the combination of PDT and CIS was applied to treat EJ138 and 5637 cell lines. Cytotoxic effects were determined by MTT assay for assessment, and synergistic effects were estimated using the Combination Index (CI); synergistic effects were observed in all groups. Also, synergistic changes in cell viability, cell migration, and colony formation ability were observed after combination treatment. Moreover, PDT, CIS, and their combination down-regulated the expression of the MMP-9 gene, which impaired cell migration, especially in combination groups. Apoptosis induction was significantly increased compared to either treatment alone. Importantly, CIS, in combination with PDT, down-regulated the PI3K/AKT/mTOR that augmented the CIS sensitivity of BLC cells. In conclusion, it can be suggested that a combination treatment of CIS and PDT has high effects on sensitizing human muscle-invasive bladder cancer cells (EJ138 and 5637 cell lines) to CIS-based chemotherapy.	bladder
Routine annual imaging does not aid in diagnosing new functional complications more than five years after RC with ileal conduit.	PURPOSE: To assess the value of routine annual imaging in identifying complications more than 5 years after radical cystectomy (RC) with ileal conduit. METHODS: We included patients with bladder cancer who underwent RC with ileal conduit between 2011 and 2018. Patients were excluded if they received no functional follow up after discontinuing oncological follow up, if there was oncological progression or if an uretero-enteric structure (UES) was diagnosed within 5 years after RC. Functional follow up consisted of annual imaging using either ultrasound or CT, along with laboratory tests. The primary outcomes were: (1) the incidence of new or progressive hydronephrosis, and (2) the incidence of imaging-diagnosed complications i.e. UES and urolithiasis. RESULTS: A total of eighty-two patients were included, with a mean follow up of 6.5 years after RC. In total, 202 ultrasounds and 71 CTs were performed. New or progressive hydronephrosis was observed in 6 imaging modalities (2.2%), in 6 different patients (7.3%). No UES cases were diagnosed following routine annual imaging. One patient was diagnosed with UES after diagnostic imaging was prompted by clinical symptoms. CONCLUSION: In our cohort, routine annual imaging beyond five years after radical cystectomy (RC) with ileal conduit rarely revealed abnormalities and did not contribute to the diagnosis of UES nor urolithiasis. However, imaging should be performed when clinically indicated.	bladder
Prognostic value of combined tumor regression grade and TNM stage in muscle-invasive bladder cancer treated with neoadjuvant chemotherapy and radical cystectomy.	INTRODUCTION: Tumor regression grade (TRG) is a recognized prognostic marker in several solid tumors treated with neoadjuvant therapy, but its clinical relevance in muscle-invasive bladder cancer (MIBC) remains under investigation. This study aimed to evaluate the prognostic value of TRG and its integration with pathological TNM staging in patients with MIBC treated with neoadjuvant chemotherapy (NAC) followed by radical cystectomy (RC). MATERIALS AND METHODS: We conducted a retrospective analysis of 51 patients with MIBC who received platinum-based NAC followed by RC and lymphadenectomy between 2013 and 2024. TRG was assessed according to the Fleischmann classification and combined with ypTNM stage to categorize patients as complete, partial or non-responders. Overall survival (OS) and disease-free survival (DFS) were estimated using Kaplan-Meier analysis, and independent prognostic factors were identified through Cox regression models. RESULTS: Complete response (ypT≤1, ypN0, TRG1) was observed in 43.1% of patients. Median OS was 19 months, with 3- and 5-year OS rates of 28.6% and 14.3%, respectively. Complete responders demonstrated significantly improved OS and DFS (p<0.001). On multivariable analysis, absence of nodal involvement (p=0.047) and complete response (p=0.012) were independently associated with better OS. Negative surgical margins showed a trend toward improved survival (p=0.064). CONCLUSIONS: TRG is a reproducible and clinically meaningful histopathologic scoring system that enhances prognostic stratification when combined with pathological TNM staging. Its integration into routine post-NAC assessment may improve postoperative decision-making and help identify patients who could benefit from tailored surveillance or adjuvant strategies.	bladder
Eosinophilic Fasciitis in a 78-Year-Old Man Following Pembrolizumab Treatment for Bladder Cancer.	BACKGROUND Immune checkpoint inhibitors (ICI) like pembrolizumab are increasingly used in cancer treatment and have become the standard of care for certain types of malignancies. Expanded use of these medications has led to more frequent recognition of immune-related adverse events (irAEs), including those presenting with sclerosing skin conditions such as eosinophilic fasciitis (EF). This case report describes the clinical presentation and management of a 78-year-old man with a history of bladder cancer who developed eosinophilic fasciitis after 6 months of treatment with an ICI. CASE REPORT Following 6 months of treatment with pembrolizumab, the patient developed capillary-leakage syndrome (CLS), which was treated with intravenous immunoglobulin (IVIG) and steroids. Several months after the resolution of his CLS, he developed painful hardening of the skin in his extremities and back, with notable induration of the skin and restricted range of motion across his elbows on physical examination. Laboratory workup revealed elevated inflammatory markers and eosinophilia. Skin biopsy revealed fibrosis of subcutaneous tissue and deep fascia, with multifocal collections of lymphocytes and plasma cells, consistent with eosinophilic fasciitis. Pembrolizumab was discontinued, and he received treatment with prednisone, mycophenolate mofetil, hydroxychloroquine, and benralizumab, with some improvement in his skin lesions. CONCLUSIONS This case report supports the need to have a high index of suspicion and investigate for eosinophilic fasciitis in cancer patients treated with anti-PD-1 medications who present with symmetric, painful hardening of the skin.	bladder
Comparison of the EndoGIA versus the Endowrist stapler in intracorporeal urinary diversion in robotic assisted radical cystectomy (EGIAES) - a randomized multicentre trial.	Despite increased surgical experience, improved perioperative care and technological advancements, postoperative ileus (POI) continuous to be a common complication following cystectomy with urinary diversion. In theory, POI can be reduced if lumen of the enteric anastomosis performed during surgery has the sufficient diameter. We aimed to evaluate different stapler types on bowel function recovery, comparing two firings of the robotic Endowrist 45 mm (EW45) stapler with the handheld EndoGia 60 mm (EG60). We hypothesized that better robotic maneuverability and a longer stapler length would create a wider anastomosis and thereby improve postoperative bowel function. This multicentre RCT was conducted between 2018 and 2021 (NCT03385798). Seventy-eight patients with bladder cancer undergoing radical cystectomy with ileal conduit were randomized 1:1 (EW45 or EG60). Time to first flatus and bowel movement was registered postoperatively and patients were followed up with the validated Bowel Function Index (BFI) preoperatively, at 3 weeks, 4 and 12 months postoperatively. The EW45 group had a higher POI rate (24% vs. 3%), longer time to first flatus (93 h vs. 71 h, p = 0.004), and longer length of hospital stay (LOS) (13 vs. 8 days, p = 0.001). No significant differences were observed in readmission, reoperation, or mortality. BFI scores did not differ between groups at any time point. Patients operated with EW45 had higher rates of POI and LOS, indicating worse outcome in the perioperative phase. However, no differences in long-term bowel function were observed and both techniques had the same risk of reoperation and mortality.	bladder
Comparison of Remimazolam and Sevoflurane on Perioperative Body Temperature Changes in Older Patients Undergoing Transurethral Resection of Prostate or Bladder Tumors Under General Anesthesia: A Randomized Prospective Clinical Trial.	PURPOSE: Perioperative hypothermia is a common complication of general anesthesia, especially in older patients undergoing transurethral resection of the prostate (TURP) or bladder tumors (TURB). Age-related thermoregulatory impairment increases vulnerability to hypothermia, and large-volume irrigation during these procedures further elevates the risk. Preclinical and clinical studies suggest that remimazolam may reduce perioperative hypothermia and shivering compared with volatile anesthetics. This study compared remimazolam and sevoflurane on perioperative body temperature (BT) changes in older patients undergoing TURP or TURB. PATIENTS AND METHODS: This prospective, randomized clinical trial enrolled 84 patients aged 65-85 years undergoing TURP or TURB under general anesthesia. Patients were randomized to receive either remimazolam (n = 42) or sevoflurane (n = 42). Preoperative tympanic temperature was measured immediately before induction, and intraoperative core BT was monitored with an esophageal temperature probe. Postoperative BT was recorded using tympanic thermometry. The primary outcome was the incidence of perioperative hypothermia (BT < 36.0°C). Secondary outcomes included intraoperative decrease in BT, incidence of profound hypothermia (BT < 35.0°C), need for active warming in the PACU, postoperative nausea, vomiting and shivering, pain scores, and perioperative hemodynamic variables. RESULTS: The change over time in BT in operating room was significantly different between 2 groups (P = 0.010). The remimazolam group exhibited significantly smaller intraoperative reductions in core BT compared to the sevoflurane group (0.83 ± 0.38°C vs 1.08 ± 0.48°C, P=0.011). The incidence of profound hypothermia occurred in the sevoflurane group (17%) and was not observed in the remimazolam group (0%) (P = 0.029). Significantly fewer patients in the remimazolam group required active warming in the PACU (19% vs 40%, P = 0.032). Hemodynamic variables and postoperative shivering rates were comparable between the groups. CONCLUSION: These findings suggest that remimazolam may offer thermoregulatory advantages in older surgical patients at high risk for hypothermia.	bladder
Case report: atypical anti-SAE1 autoantibody manifestation with splinter hemorrhages as onset, and related to urothelial cancer.	BACKGROUND: Subungual splinter hemorrhages may represent an expression of infective endocarditis as well as autoimmune diseases or neoplasms. Anti-SAE1 autoantibody is directed against a small ubiquitin-like modifier-activating enzyme that plays a role in regulating transcription, cell cycle, and apoptosis. It is specific for dermatomyositis with skin rash and mild muscle involvement, and it can be associated with cancer.  CASE REPORT: We describe the case of a patient who developed subungual splinter hemorrhages and acrocyanosis. Infections were excluded, and autoimmunity resulted in anti-SAE1 autoantibodies. A cancer screening found a high-grade urothelial carcinoma. The splinter hemorrhages disappeared after the carcinoma enucleation.  CONCLUSIONS: Our case describes an atypical onset of anti-SAE1 dermatomyositis with splinter hemorrhages, potentially linked to urothelial cancer. This highlights the importance of comprehensive cancer screening in patients with unusual dermatomyositis presentations. GRAPHICAL ABSTRACT: https://www.europeanreview.org/wp/wp-content/uploads/Graphical-Abstract-rev.jpg.	bladder